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Menopause: Managing Hot Flashes

Introduction

Most women have
hot flashes at some point before or after
menopause. Hot flashes happen when
estrogen levels drop. While some women have
few to no hot flashes, others have them many times each day.

Hot flashes can be uncomfortable and upsetting. They can lower the quality of your sleep and daily life. But they aren't a sign of a medical problem. They are a normal
response to natural changes in your body.

Hot flashes usually get better or go away
after the first or second year after menopause. At that point, estrogen levels
usually stay at a low level.

You can make some lifestyle changes to reduce your hot flashes. And if those don't help, you may want to try medical treatment.

Avoid using tobacco or drinking a lot of alcohol. They tend to make hot
flashes worse.

Manage stress. Stress can make hot flashes worse.

Exercise regularly, and eat a healthy diet.

Try rhythmic breathing exercises. This is called paced respiration. It can help you meditate and
relax, and it may reduce your hot flashes.

You also can talk to your doctor about treatments that may either
reduce or stop your hot flashes. These include taking low-dose
estrogen (hormone therapy) for a short time, taking certain medicines, and taking the herb black cohosh.

How can I manage hot flashes?

You can manage hot
flashes by making certain lifestyle choices. You can also take daily medicine.
Some measures help prevent or reduce hot flashes. Others can make you more
comfortable when you're having a hot flash.

Lifestyle choices

Eat and drink well, and avoid smoking

Eat smaller, more frequent meals. Digesting a lot of food can make you feel hotter.

Eat healthy foods.

Do not smoke or
use other forms of tobacco.

Stay cool

Keep your area cool. Use a
fan.

Dress in layers. Then you can remove clothes as
needed.

Wear natural fabrics, such as cotton and
silk.

Sleep with fewer blankets.

Reduce stress

Get regular exercise.

Use relaxation techniques, such as
breathing exercises,
yoga, or
biofeedback. A breathing exercise
called paced respiration may reduce hot flashes and emotional symptoms.

Medical treatment

Short-term, low-dose
hormone therapy (HT) can reduce or stop
hot flashes and other menopause symptoms. It raises your estrogen
level. Use the lowest dose needed for the shortest possible time, and have
regular checkups. This is because HT
may increase the risk of problems in a small number of women. These problems include blood clots, stroke,
heart disease, breast cancer, ovarian cancer, and dementia. Risk varies based on when you start HT in menopause and how long you take it. Using HT for a short time in early menopause has less risk than when it is started later in menopause.footnote 1, footnote 2 If you have a history of heart disease or breast
cancer, avoid using estrogen for hot flashes. There are other options.

Estrogen-progestin birth control pills (before
menopause) can reduce or stop hot flashes and other symptoms. They can keep your hormones from going up and down. Don't use estrogen if
you are older than 35 and smoke; have
diabetes, heart disease, or breast cancer; or
have a
family history of breast cancer.

Antidepressant medicine can reduce the number of hot flashes and how bad they are. It improves the brain's use of serotonin, which helps
control body temperature. Side effects are possible.
This type of medicine is a good choice if your only menopause symptoms are having hot flashes and mood swings and feeling irritable.footnote 3

Clonidine may relieve hot flashes for some women. But studies have not shown that it makes hot flashes less severe or less frequent.footnote 4 This type of medicine is a good choice if
hot flashes are your only symptom, especially if you have high
blood pressure.

Gabapentin, an antiseizure medicine, may lower the number of hot flashes each day. It also may make hot flashes less severe.footnote 3

Black cohosh may reduce or prevent hot flashes,
depression, and anxiety. As with HT, have regular checkups when you take
black cohosh.

Some women eat and
drink a lot of soy to even out hot flashes and other symptoms.
So far, studies have used many different soy sources and different measures of how well they work. So this makes it hard to compare them. Soy isoflavone (rather than soy protein) has shown the most promise to treat hot flashes.footnote 5

References

Citations

North American Menopause Society (2012). The 2012 hormone therapy position statement of the North American Menopause Society. Menopause, 19(3): 257–271. http://www.menopause.org/docs/default-document-library/psht12.pdf?sfvrsn=2. Accessed August 27, 2015.

North American Menopause Society (2015). The North American Menopause Society statement on continuing use of systemic hormone therapy after age 65. Menopause, 22(7): 693. http://www.menopause.org/docs/default-source/2015/2015-nams-hormone-therapy-after-age-65.pdf. Accessed August 24, 2015.

Shifren JL, et al. (2010). Role of hormone therapy in the management of menopause. Obstetrics and Gynecology, 115(4): 839–855.

North American Menopause Society (2012). The 2012 hormone therapy position statement of the North American Menopause Society. Menopause, 19(3): 257–271. http://www.menopause.org/docs/default-document-library/psht12.pdf?sfvrsn=2. Accessed August 27, 2015.

North American Menopause Society (2015). The North American Menopause Society statement on continuing use of systemic hormone therapy after age 65. Menopause, 22(7): 693. http://www.menopause.org/docs/default-source/2015/2015-nams-hormone-therapy-after-age-65.pdf. Accessed August 24, 2015.

Shifren JL, et al. (2010). Role of hormone therapy in the management of menopause. Obstetrics and Gynecology, 115(4): 839–855.

North American Menopause Society (2011). The role of soy isoflavones in menopausal health: Report of the North American Menopause Society. Menopause, 18(7): 732–753.

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